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Acute myocardial infarction: profile and management at a tertiary care hospital in Karachi.

Publication ,  Journal Article
Samad, Z; Rashid, A; Khan, MAU; Mithani, S; Khan, MH; Khan, MSM; Malik, SS; Nehal, US; Sami, S; Karim, M
Published in: J Pak Med Assoc
January 2002

OBJECTIVE: Acute Myocardial Infarction (AMI) is a rising epidemic in developing countries. While studies in the West have established the characteristics and management of AMI patients, comprehensive data reflecting these issues in the Pakistani subjects is scarce. This study examined the profile and management of AMI in patients hospitalized at a tertiary care hospital in Karachi, Pakistan. METHODS: Three hundred forty four patients admitted in 1998 with the diagnosis of AMI met our inclusion criteria. Data on presentation, investigations, monitoring and therapy was obtained. Chi-square and t tests were used to analyze the data. RESULTS: Out of 344 patients with AMI, 71% were males; 58% had a Q wave MI. Majority of the patients who presented within 2 hours of symptom onset (36%), had chest pain. Patients with dyspnea and no chest pain were more likely to present after 12 hours of the onset of symptoms. In-house mortality was found to be 10.8%. Low HDL and diabetes was associated with in-hospital complications. Twenty nine percent of patients were given thrombolytic therapy with a mean door-to-needle time of 1 hour 36 minutes; 33% of patients who were eligible of Streptokinase did not receive it. Cardiac catheterization was performed in 28% patients. Echocardiography and Exercise Tolerance Test, both under utilized, were performed in 67% and 16% of patients, respectively. Two hundred sixteen (70%) patients discharged from hospital were contacted via telephone and the 1-year mortality rate among them was 28%. CONCLUSION: The profile and management of AMI was in coherence with earlier, Western studies. Chest pain units need to be established in the Emergency Room. Patients should be risk stratified prior to discharge. Public awareness regarding primary and secondary prevention and symptoms of AMI needs to be increased.

Duke Scholars

Published In

J Pak Med Assoc

ISSN

0030-9982

Publication Date

January 2002

Volume

52

Issue

1

Start / End Page

45 / 50

Location

Pakistan

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Pakistan
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
  • Hospital Mortality
  • General & Internal Medicine
 

Citation

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Samad, Z., Rashid, A., Khan, M. A. U., Mithani, S., Khan, M. H., Khan, M. S. M., … Karim, M. (2002). Acute myocardial infarction: profile and management at a tertiary care hospital in Karachi. J Pak Med Assoc, 52(1), 45–50.
Samad, Z., A. Rashid, M. A. U. Khan, S. Mithani, M. H. Khan, M. S. M. Khan, S. S. Malik, U. S. Nehal, S. Sami, and M. Karim. “Acute myocardial infarction: profile and management at a tertiary care hospital in Karachi.J Pak Med Assoc 52, no. 1 (January 2002): 45–50.
Samad Z, Rashid A, Khan MAU, Mithani S, Khan MH, Khan MSM, et al. Acute myocardial infarction: profile and management at a tertiary care hospital in Karachi. J Pak Med Assoc. 2002 Jan;52(1):45–50.
Samad, Z., et al. “Acute myocardial infarction: profile and management at a tertiary care hospital in Karachi.J Pak Med Assoc, vol. 52, no. 1, Jan. 2002, pp. 45–50.
Samad Z, Rashid A, Khan MAU, Mithani S, Khan MH, Khan MSM, Malik SS, Nehal US, Sami S, Karim M. Acute myocardial infarction: profile and management at a tertiary care hospital in Karachi. J Pak Med Assoc. 2002 Jan;52(1):45–50.

Published In

J Pak Med Assoc

ISSN

0030-9982

Publication Date

January 2002

Volume

52

Issue

1

Start / End Page

45 / 50

Location

Pakistan

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Pakistan
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
  • Hospital Mortality
  • General & Internal Medicine